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활동중심중재와 체외충격파치료를 적용한 경직형 뇌성마비의 재활치료

Rehabilitation Therapy of Spastic Cerebral Palsy with Activity-Based Intervention and Radial Extracorporeal Shock Therapy

최은영
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2023.12|특수교육재활과학연구|제62권 제4호|pp. 99-115

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참고문헌

키워드

뇌성마비Cerebral palsy경직Spasticity체외충격파활동중심중재Activity-based trainingRadial extracorporeal therapy
주제분류기타사회과학

초록

근경직은 뇌성마비 아동에게 장애를 유발한다. 체외충격파는 경직을 감소시키는데 효과적인 치료방법이라는 근거가 증가하고 있다. 경직을 관리하는 궁극적인 목표는 보행과 같은 기능을 향상시키는 것이다. 본 연구의 목적은 활동중심중재와 함께 적용한 방사형 체외충격파치료가 경직형 뇌성마비 아동의 발바닥 굽힘근의 경직, 정적 균형과 보행에 미치는 영향을 알아보고자 한다. 경직형 뇌성마비 아동 12명을 대상자로 모집하였으며, 무작위로 실험군 6명과 대조군 6명으로 나누었다. 모든 대상자는 8주간 주 3회 활동중심훈련 프로그램에 참여하였으며, 실험군은 같은 기간 동안 주 1회 체외충격파치료도 함께 받았다. 중재 전과 후의 근경직도, 정적 균형(동요면적, 동요거리), 보행(속도, 걸음수)를 측정하였다. 실험군에서 측정된 근경직도, 정적 균형, 보행변수는 대조군과 비교하였을 때 유의한 향상을 나타냈다(p<.05). 본 연구결과는 체외충격파가 물리치료에 추가적인 방법으로 적용될 수 있을 것이며, 경직형 뇌성마비 아동의 보행과 균형을 향상시키는데 도움을 줄 수 있을 것이다.

Abstract

Muscle spasticity causes disability in children with cerebral palsy. There's growing evidence that radial extracorporeal shock wave therapy (rESWT) is an effective treatment method for reducing spasticity. The ultimate goal of managing spasticity is to improve functions such as walking. The purpose of this study was to investigate the effects of radial extracorporeal shock wave therapy combined with activity-based intervention on the spasticity of the plantar flexor muscles, static balance, and gait in children with spastic cerebral palsy. Twelve children with spastic cerebral palsy were recruited and randomly divided into two groups: six in the experimental group and six in the control group. All participants engaged in an activity-based training program three times a week for eight weeks, and those in the experimental group also received rESWT once a week. Muscle stiffness, static stability(sway length, sway area), and gait parameter(velocity, cadence) were measured before and after the intervention. The experimental group showed significant improvements in muscle stiffness, static stability, and gait variables compared to the control group (p<.05). The results of this study suggest that rESWT can be applied as an additional method in physical therapy, and it may help children with spastic cerebral palsy improve their walking and balance abilities.

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